Sign up to receive free email alerts when patent applications with chosen keywords are publishedSIGN UP

Abstract:

A method of increasing movement of a tooth in a jaw having at least one
tooth with an orthodontic brace thereon includes: (1) holding a handle of
a device, the device having an elongate member extending from the handle
and a screw tip at a distal end of the elongate member; (2) moving a
sleeve along the elongate member to set a length of exposed screw tip;
(3) locking the sleeve in place relative to the screw tip; (4) drilling a
hole with the screw tip through a cortical bone of a jaw to increase
movement of the tooth; and (5) stopping the drilling when the length of
exposed screw tip has penetrated the jaw.

Claims:

1. A method of increasing movement of a tooth in a jaw, the method
comprising: holding a handle of a device, the device having an elongate
member extending from the handle and a screw tip at a distal end of the
elongate member; moving a sleeve along the elongate member to set a
length of exposed screw tip; locking the sleeve in place relative to the
screw tip; drilling a hole with the screw tip through a cortical bone of
a jaw, wherein the jaw comprises at least one tooth having an orthodontic
brace thereon, the drilling performed to increase movement of the tooth;
and stopping the drilling when the length of exposed screw tip has
penetrated the jaw.

2. The method of claim 1, wherein drilling a hole comprises drilling a
hole in a mesial surface of the jaw.

3. The method of claim 2, further comprising drilling a plurality of
holes spaced along a mesial surface of the jaw.

4. The method of claim 1, wherein drilling a hole comprises drilling a
hole in a gingival flap.

5. The method of claim 1, wherein drilling a hole comprising drilling the
hole proximal to a central or lateral tooth or drilling a hole in the
palatal.

6. The method of claim 5, wherein the length of exposed screw tip is
approximately 3 mm.

7. The method of claim 1, wherein drilling a hole comprises drilling the
hole in a canine or a premolar.

8. The method of claim 7, wherein the length of exposed screw tip is
approximately 5 mm.

9. The method of claim 1, wherein drilling a hole comprises drilling the
hole proximal to posterior molars or in the mandible.

10. The method of claim 9, wherein the length of exposed screw tip is
approximately 7 mm.

Description:

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation of U.S. patent application Ser.
No. 13/471,099, filed May 14, 2012, titled "METHOD AND DEVICE FOR CAUSING
TOOTH MOVEMENT," now U.S. Patent Application Publication No.
2012-0288814-A1, which claims priority to U.S. Provisional Patent
Application No. 61/486,038, filed May 13, 2011, and titled "METHOD AND
DEVICE FOR CAUSING TOOTH MOVEMENT," each of which is herein incorporated
by reference in its entirety.

INCORPORATION BY REFERENCE

[0002] All publications and patent applications mentioned in this
specification are herein incorporated by reference to the same extent as
if each individual publication or patent application was specifically and
individually indicated to be incorporated by reference.

FIELD

[0003] The present disclosure relates to dental and orthodontic devices
and methods, particularly devices and methods for increasing the movement
of teeth in the jaw.

BACKGROUND

[0004] A large percentage of today's children and adult population
undergoes orthodontic treatments at some point in their lives to treat
malocclusions (i.e. crooked teeth leading to poor bite) or improve
skeletal abnormalities. Because growth and development of adult teeth is
generally stagnant, treatment of malocclusions in adults requires
reliance on the dento-alveolar element, e.g. the ability of teeth to move
when a sufficient inflammatory response is created in the jaw.

[0005] The most common method of creating movement in teeth is through the
use of braces. The braces include wires and other tensioning devices,
such as rubber bands and coils or removable trays, that exert a
continuous force on the tooth to move the tooth to a desired location.
The use of braces to cause tooth movement, however, takes on average
18-24 months and can take up to 3-4 years, often causing both social and
physical discomfort. Accordingly, it would be advantageous to have a
treatment method that could successfully move a tooth or teeth in a
shorter period of time.

SUMMARY OF THE DISCLOSURE

[0006] In general, in one aspect, a device for increasing movement of a
tooth in a jaw includes a handle, an elongate member extending from the
handle, a screw tip at a distal end of the elongate member, and a sleeve.
The screw tip is configured to drill into the cortical bone of the jaw to
increase movement of the tooth. The sleeve is configured to move along
the elongate member to vary the length of exposed screw tip.

[0007] In general, in one aspect, a method of increasing movement of a
tooth in a jaw includes moving a sleeve along an elongate member of a
device to set a length of exposed screw tip; drilling a hole with the
screw tip through a cortical bone of a jaw, wherein the jaw comprises at
least one tooth having an orthodontic brace thereon; and stopping the
drilling when the length of exposed screw tip has penetrated the jaw.

[0008] These and other embodiments can include one or more of the
following features.

[0009] The sleeve can be configured to move along the elongate member to
set the length of the exposed screw tip at between 0 mm and 10 mm. The
sleeve can be configured to move along the elongate member in 1/2 mm
increments.

[0010] The handle can further include a button configured to control
movement of the sleeve. The handle can include a first end attached to
the elongate member and a second end, and the first end can be rotatable
with respect to the second end. The first end can be configured to
control rotation of the screw.

[0011] A hole can be formed in a distal, mesial, facial or lingual surface
of the jaw. There can be a plurality of holes formed along the mesial
surface of the jaw. A hole can be formed into a gingival flap. A hole can
be formed without cutting away gingival flap prior to forming the hole.
The exposed screw tip can be approximately 3 mm, for example when the
hole is drilled proximal to a central or lateral tooth or in the palatal.
The exposed screw tip can be approximately 5 mm, for example when the
hole is drilled proximal to a canine or a premolar. The exposed screw tip
can be approximately 7 mm, for example when the hole is drilled proximal
to a posterior molar or in the mandible. The sleeve can be configured to
act as a drill stop.

[0012] The device can further include a pressure transducer at the distal
end of the sleeve. There can be a pressure indicator on the handle, and
the pressure indicator can be configured to indicate the pressure
measured by the pressure transducer.

[0013] The handle can include a plunger and a torque translator, and axial
movement of the plunger can cause rotation of the screw tip.

BRIEF DESCRIPTION OF THE DRAWINGS

[0014] The novel features of the invention are set forth with
particularity in the claims that follow. A better understanding of the
features and advantages of the present invention will be obtained by
reference to the following detailed description that sets forth
illustrative embodiments, in which the principles of the invention are
utilized, and the accompanying drawings of which:

[0015]FIG. 1A shows an embodiment of a dental device having an exposed
screw tip.

[0019] FIG. 4 shows a close-up of the screw tip of the device of FIG. 1A.

[0020] FIGS. 5A-5B show an embodiment of a dental device having a pressure
transducer to determine when the screw trip has reached a particular
depth.

[0021] FIGS. 6A-6B show an embodiment of a dental device having a
separable handle and shaft.

[0022]FIG. 7 shows an embodiment of a dental device having a plunger and
torque translator to cause rotation of the screw tip.

[0023] FIGS. 8A-8I show an embodiment of a dental device having a ratchet
knob to set the screw tip and predetermined lengths.

[0024] FIGS. 9A-9E shows an embodiment of a dental device having a screw
tip with holes therein for fluid delivery.

[0025]FIG. 10A shows a microperforation dental device having a
mechanically powered distal tip. FIG. 10B shows a microperation dental
device having a laser on the distal end. FIG. 10C shows a
microperforation dental device having a radiofrequency source on the
distal end. FIG. 10D shows a microperforation dental device having a
water jet on the distal end.

[0026] FIGS. 11A and 11B show use of a dental device to create
microperforations.

[0027]FIG. 12 is a chart summarizing results obtained during studies of
the use of the dental device described herein.

DETAILED DESCRIPTION

[0028] Referring to FIGS. 1-4, a device 100 is a hand-held instrument to
create micro-osteoperforation in bone and soft tissue, i.e. the device
100 can be used to increase the movement of a tooth in a jaw. The device
100 includes a handle 101 and an elongate shaft 103 extending from the
handle 101. A screw tip 105, for example made of stainless steel, can be
located at the distal end of the elongate shaft 103. A sleeve 107 can be
configured to move along the elongate shaft 103 to vary the length of
exposed screw tip 105 (the screw tip 105 is shown exposed in FIG. 1A and
fully covered in FIG. 1B).

[0029] The sleeve 107 can be released by a release mechanism, such as a
button 109 on the handle 101. When compressed, the button 109 can allow
the sleeve 107 to move along the shaft 103, and when released, the button
109 can lock the sleeve 107 in place. The button 109 can thus allow the
screw tip 105 to be set at a desired length, for example at a length of
between 0 mm and 10 mm. Further, in some embodiments, the device 100 can
be configured to lock the length at specific increments, for example 1/2
mm increments. The sleeve 107, by covering all of the screw tip except
the exposed portion, can act as a perforation tip depth stop to prevent
the screw tip 105 from penetrating the bone beyond the targeted depth.

[0030] The shaft 103 and screw tip 105 can be rotatable with respect to
the handle 101 or a portion of the handle 101. For example, the handle
101 can include a first end 111 attachable to the shaft 103 and a second
end 113 configured to be held stationary by the user. The first end 111
can be rotatable with respect to the second end 113 so as to control
rotation of the shaft 103, and hence rotation of the screw tip 105.

[0031] Referring to FIGS. 5A and 5B, in some embodiments, the dental
device 100 can further include a pressure transducer 119 on the distal
end of the sleeve 107 to determine when the screw tip 105 has fully
penetrated the jaw or reached the predetermined depth. An indicator
mechanism, such as an indicator light 121 on the handle 101, can be used
to indicate that the screw tip 105 has penetrated the jaw fully. For
example, the indicator light 121 can change colors from a dark color (see
FIG. 5A), such as green, to a light color (see FIG. 5B), such as yellow,
to indicate that the pressure transducer 112 has reached the patient's
gums or when the pressure transducer 119 has measured a preset pressure.

[0032] In some embodiments, referring to FIGS. 6A-6B, a dental device 600
can include a shaft 603 that is separable from the handle 601. The shaft
603 can include a screw tip 605 attached thereto. In some embodiments,
the screw tip 605 can be always exposed, i.e., not be coverable by a
sleeve and/or have variable length settings. The screw tip can have a
length between 0 and 6 mm. Similar to the dental device 100, the shaft
603 and screw tip 605 can be rotatable with respect to the handle 601 or
a portion of the handle 601. For example, the handle 601 can include a
first end 611 attachable to the shaft 603 and a second end 613 configured
to be held stationary by the user. The first end 611 can be rotatable
with respect to the second end 613 so as to control rotation of the shaft
603, and hence rotation of the screw tip 605. The shaft 603 can include
an attachment portion 661 that is configured to snap or screw into the
handle 601. For example, as shown in FIGS. 6A and 6B, the attachment
portion can include teeth configured to interlock with teeth inside the
handle 601. Further, the shaft 603 can snap in and out of the handle 601
through a release mechanism, such as a button 619. In some embodiments, a
spring can be included proximal to the release mechanism to urge the
shaft 603 out of the handle 601 when the release mechanism is activated.
Advantageously, by having the shaft 603 be removable from the handle 601,
the handle 601 can be used with different shafts 603, thereby allowing
the shafts 603 to be disposable and the handle 601 to be reusable.

[0033] Referring to FIG. 7, a dental device 200 can include many of the
same elements as the dental device 100, such as the screw tip 205, sleeve
207, and handle 201. The handle 201 can include a plunger 231 and a
torque translator 233 such that axial movement of the plunger 231 causes
rotation of the screw tip 205. Further, the handle 201 can include wings
235a, 235b to allow for better gripping of the handle. Similar to the
embodiment of FIG. 5, the dental device 200 can include a pressure
transducer 219 to determine when the screw tip 205 has reached the
patient's gums. In contrast to the single indicator of FIG. 5, the device
200 can include multiple indicators. For example, there can be two
indicator lights 221a, 221b to indicate when the pressure transducer 219
has reached the gums, i.e. has sensed a preset pressure. For example,
indicator light 221 a can be a green light that indicates that the screw
tip 205 can be advanced further, while indicator light 221 b can be a red
light indicating that the screw tip 205 should not be advanced further.

[0034] Referring to FIGS. 8A-8E, a dental device 800 can include a handle
801 and a shaft 803 having a screw tip 805 attached thereto. Similar to
other embodiments described herein, the shaft 803 and screw tip 805 can
be rotatable with respect to the handle 801 or a portion of the handle
801. For example, the handle 801 can include a first end 811 attachable
to the shaft 803, such as via pins 875 (see FIG. 8D). Further, the second
end 813 configured to be held stationary by the user. The first end 811
can be rotatable with respect to the second end 813 so as to control
rotation of the shaft 803, and hence rotation of the screw tip 805. In
the embodiment of FIGS. 8A-8E, almost the entire device can be rotatable
except for a small second end 813. As a result, the second end 813 can be
used to place distally-directed pressure on the device 800 to help
puncture the tissue while the rest of the device can rotate to assist in
screwing the screw tip 805 into the tissue.

[0035] A sleeve 807 can be configured to move within the handle 801 and
axially along the shaft 803 to vary the length of the exposed screw tip
805 (the screw tip 805 is shown exposed in FIG. 8B and fully covered in
FIG. 8A). A ratcheting mechanism 881 can be used to set the sleeve 807 at
the desired length. For example, the ratcheting mechanism 881 (see FIGS.
8C-8E) can be set such that the screw tip 805 is exposed at 2 mm
increments, such as at 0 mm, 3 mm, 5 mm, and 7 mm. The ratcheting
mechanism 881 can include a rotatable ratchet nob 883 that can be used to
set the sleeve 807 such that the screw tip 805 is exposed at the desired
length. The ratchet nob 883 can be attached to a plurality of ratchet
stops 885 having different axial lengths. The ratchet nob 883 and ratchet
stops 885 can be rotatable within the handle 801 with respect to a
locking portion 887. The locking portion 887 can include a lock stop 889
configured to engage with one of the ratchet stops 885 to set the exposed
length of the screw tip 805. Further, a spring 891 can bias the shaft 803
and screw tip 805 distally. Thus, as shown in FIG. 8D, the sleeve 807
will continue to cover the screw tip 805 until a proximal force is placed
on the sleeve 807, such as by tissue. Referring to FIG. 8E, once the
proximally directed force is placed on the sleeve 807, the sleeve 807
will move proximally against the spring 891 until the lock stop 889
engages with the set ratchet stop 885. If a different length of exposed
screw tip 805 is desired, the ratchet nob 883 can be rotated, thereby
rotating the ratchet stops 885 such that the lock stop 889 is forced to
engage with a ratchet stop 885 that is of a different axial length.

[0036] The position of the ratchet stops 885 relative to the lock stop 889
for an exemplary device with four settings of 0 mm, 3 mm, 5 mm, and 7 mm,
are shown in FIGS. 8F-8I. For example, in FIG. 8F, the lock stop 889 is
in contact with a ratchet stop 885a at the 7 mm position, thereby
exposing 7 mm of the screw tip 805. In FIG. 8G, the lock stop 889 is in
contact with a ratchet stop 885b at the 5 mm position, thereby exposing 5
mm of the screw tip 805. In FIG. 8H, the lock stop 889 is in contact with
a ratchet stop 885c at a 3 mm position, thereby exposing 3 mm of the
screw tip 805. Finally, in FIG. 8I, the lock stop 889 is in contact with
a ratchet stop 885d at a 0 mm position, thereby keeping the screw tip 805
fully exposed.

[0037] Referring to FIGS. 8A-8E, the distal end 880 of the sleeve 807 can
be configured to sit against the outer portion of the gums after the
screw tip 805 has fully penetrated the gums. Further, a pressure
transducer, such as an LED indicator 888, can be used in the device 800
to indicate when the screw tip 805 has reached the desired depth in the
tissue. The LED indicator 888 can work, for example, by including a
battery 893 with a flexible negative lead 895 in contact with the battery
893 and a positive lead 897 spaced away from the battery 893, such as
with a compression spring 899. Both leads 895, 897 can be connected to an
LED light 898. As the sleeve 807 makes contact with the ratchet stops
885, the positive lead 897 can be pushed against the battery 893. When
contact is made, the LED light 898 can turn on, which can shine light
through the LED indicator 888, indicating that the desired screw length,
and thus the desired microperforation depth, has been achieved.

[0038] Referring to FIGS. 8A-8C, the handle 801 can be made of two or more
pieces of material connected together. In order to prevent torque, i.e.,
torque caused during rotation of the screw tip 805 to cause
microperforation, at least some of the joints can include undulations 896
at the seams.

[0039] Referring to FIGS. 9A-9E, in one embodiment, a dental device 700
can include a handle 701 and a shaft 703 having a screw tip 705 attached
thereto. The device 700 can include any of the features of the devices
described above, e.g., can include a rotatable portion and a stationary
portion, a sleeve configured to expose the screw tip, etc. The device 700
can be configured to deliver a fluid, such as anesthesia, near or into
the tissue during use. A fluid cartridge 770 can be located inside the
handle 701 and be configured to hold delivery fluid therein. Further, the
screw tip 705 can include holes 771 (see FIG. 9E) extending therethrough,
for example, the screw tip 705 can be porous, to allow the fluid to pass
therethrough. In one embodiment, the screw tip 705 can be formed of
stainless steel, for example 17-4 stainless steel, and can be annealed
and heat treated to form the holes 771. The holes 771 can be configured
to allow a fluid, such as anesthesia, to pass through the screw tip 705.
A hypodermic needle 773 can be connected to the shaft 703, which can
puncture the fluid cartridge 770 when pressure is applied thereto by a
plunger 775. Accordingly, fluid from the cartridge 770 can travel through
the fluid path in the shaft 703 and screw tip 705 and out through the
holes 771 to be delivered to the patient.

[0040] The plunger 775 of the device 700 can be a threaded plunger that
shuttles axially, such as by rotating a knob. As shown in FIGS. 9A and
9B, when moved distally, the plunger 775 can be configured to push the
cartridge 770 toward the hypodermic needle 773 to puncture the cartridge
770. As shown in FIGS. 9A and 9B, after the hypodermic needle 773 has
punctured the cartridge 770, the plunger 775 can be configured to
dispense fluid as the plunger is moved further distally. A compression
spring 777 can prevent the cartridge 770 from being accidentally
punctured by the hypodermic needle 773 when the plunger is in the
retracted position. The screw tip 705 and/or fluid delivery aspects of
the dental device 700 can be used with any of the devices 100, 200, 300
described herein.

[0041] In some embodiments, the devices described herein can be single use
devices. Further, in some embodiments, the devices described herein can
be operated using manual power. In other embodiments, the devices
described herein can be operated electric power. Further, in some
embodiments, different energy sources can be used in place of the screw
tip. For example, the device can be powered with a power source (see FIG.
10A), such as to rotate a distal screw or apply vibratory forces, can
include a laser in the distal end (see FIG. 10B), can include a
radiofrequency source on the distal end (see FIG. 10C), or a water jet on
the distal end (see FIG. 10D). One or more of these energy sources can be
used in place of or in addition to the screw tip of the devices described
herein.

[0042] In use, any of the devices 100, 200, 300, 600, 800, 900 described
herein can be used to enhance the movement of a tooth or teeth in a jaw.
For example, referring to FIGS. 11A and 11B, the device 100 can be used
to form perforations or holes 1111 in the jaw 1113 of a patient, called
"osteoperforation." To do so, the button 109 can be depressed while
pulling the sleeve 107 toward the handle 101 to extend the screw tip 105.
The sleeve 107 can be adjusted to obtain the desired length of screw tip
105. The button 109 can then be released, locking the screw tip 105 at
the desired length. The device 100 can be held at approximately a 90
degree angle to the patient's gingival while keeping the tissue taunt.
The screw tip 105 can be rotated against the gums by rotating the handle
101, for example in a clockwise direction. Pressure can be applied to the
device 100, which, in combination with the rotation of the screw tip 105,
can cause a cutting edge of the screw tip to form one or more holes, such
as between 1 and 10 holes, for example approximately 3 holes, in the
gingival flap of the jaw 113, for example through a mesial surface of the
jaw and/or through cortical bone of the jaw. Each hole in the jaw can be
formed without cutting away a gingival flap prior to formation of the
hole. Further, each hole can be formed in the cortical bone near a
malocclusion sought to be treated. The pressure and rotation can be
stopped when the desired depth has been reached, i.e. when the screw tip
105 has been advanced all the way into the jaw and further penetration
has been stopped by the sleeve 107. Holes of between 0 mm and 10 mm deep
can be formed, such as holes of approximately 3 mm, 5 mm, or 7 mm. The
handle 101 can be rotated in the opposite direction, for example
counter-clockwise, to remove the device from the jaw. In is to be
understood that the other devices described herein can work in a similar
fashion.

[0043] Referring to FIG. 11B, in some embodiments, the devices described
herein, such as device 100, can be used in conjunction with braces 999 or
other orthodontic devices.

[0044] The holes 1111 formed in the jaw 1113 can create an inflammatory
response within the jaw. As a result, osteoclast precursors and cytokines
can be drawn to the site of the holes 1111. The cytokines can promote
osteoclast formation and activation, causing increased bone remodeling
and movement. The holes 1111 formed in the jaw 1113 can thus allow a
tooth or teeth to move over time to partially or fully treat the
malocclusion.

[0045] The devices described herein can be used to correct major molar
uprighting, major lower molar protraction, major canine protraction, and
major intrusion. Referring to FIG. 12, the devices described herein can
be used to treat a variety of conditions, such as reducing large gaps
between teeth caused by extractions, increasing the gap between teeth to
make space for implants, reducing overjet and overbite, and reducing
overcrowding (see column B). The time required for treatment of such
conditions using the devices described herein (see column E) can be
significantly reduced relative to the established traditional time for
treatment with braces (see column D). When ostoperforation is used with
the devices described herein, the treatment time for such malocclusions
can be decreased by over 30%, such as over 40%, for example by more than
50%, relative to the use of braces. For example, the time for treatment
can be reduced from 8 months to 4 months, 2 months to 4 weeks, 6 months
to 3 months, 12 months to 5 months, 24 months to 11 months, 24 months to
13 months (see columns D and E).

[0046] Advantageously, all of the devices described herein can be
configured to have an adjustable-length screw tip. The adjustable length
allows the devices to be controlled more precisely during the formation
of holes and therefore allows the devices to be accurately and safely
used in bone of different thicknesses and/or densities. Accurate and safe
use of the device in bone of different thicknesses and/or densities
allows the device to be used in different patients and in different types
of teeth. For example, the maxilla is thinner than the mandible and
therefore requires the formation of holes of a smaller depth than holes
formed in the mandible. Likewise, the depth of penetration required to
perforate through cortical bone into cancellous bone increases when
moving from the maxilla or mandible posteriorly. As another example, an
athletic male patient will typically have thicker and/or denser teeth
than a young female or an elderly woman. Accurately and safely setting
the screw tip length, and thus the depth of penetration, can allow the
device to be used in any of these scenarios. Further, the same device
could advantageously be used to drill holes of different depths near two
different teeth of the same patient.

[0047] In one aspect, the screw tip can be set to approximately 3 mm when
forming holes proximal to a central or lateral tooth or in the palatal.
In another aspect, the screw tip can be set to approximately 5 mm when
forming holes proximal to a canine, a premolar, or a molar in a female or
a small male. In another aspect, the screw tip can be set to
approximately 7 mm when forming holes proximal to posterior molars, in
the mandibular, or in the maxillary in large men.

[0048] Use of the device described herein for osteoperforation
advantageously taps a bone metabolism process that safely accelerates
motion. The microperforation process using the devices described herein
is safe, simple, and produces local alveolar bone reactions that enable
rapid motion of teeth. Further, the process can be performed in-office
and, as described above, can be performed precisely for a broad range of
patients and in a broad range of different types of teeth.

Patent applications by Bryce A. Way, San Jose, CA US

Patent applications by Christopher U. Phan, San Leandro, CA US

Patent applications by Dana Leigh Gelman Keiles, Mt. Kisco, NY US

Patent applications by Phillip Abatelli, Wesbury, NY US

Patent applications by Richard Johnson, Briarcliff Manor, NY US

Patent applications in class Method of positioning or aligning teeth

Patent applications in all subclasses Method of positioning or aligning teeth